Purpose <p>Childhood, adolescent, and young adult (CAYA) cancer survivors are at risk of HPV-related cancers, yet HPV vaccination remains lower than in the general population. The purpose of this study was to examine HPV vaccination initiation and completion among CAYA survivors and to assess the influence of sociodemographic and cancer-specific factors on vaccination.</p> Methods <p>We used data from the St. Jude Lifetime Cohort, 5 + year cancer survivors, treated at St. Jude Children’s Research Hospital, eligible for HPV vaccination since 2006 (year of FDA licensure in the USA). Primary outcomes were HPV vaccination initiation and completion. HPV vaccination was assessed between 2011 and 2020. We performed descriptive statistics and evaluated associations using univariate and multivariable logistic regression analysis using SAS version 9.4.</p> Results <p>We included 2907 CAYA survivors. HPV vaccination initiation was reported by 27.31% survivors. Among those who initiated, 71.16% survivors completed vaccination series. Female survivors compared to male survivors (OR, 2.58; 95% CI, 2.10–3.17), those age 27 + compared to 9–17 years (OR, 0.21; 95% CI, 0.10-0.42), those with a college degree or higher compared to those with a high school degree (OR, 2.39; 95% CI, 1.40–4.06), and those with insurance compared to those without insurance (public, OR, 2.00; 95% CI, 1.22–3.28; private, OR, 2.26; 95% CI, 1.41–3.63) had higher vaccination initiation. Cancer diagnosed at a later age (9–14&#xa0;years, OR, 1.59; 95% CI, 1.20-2.09; 15–24 years, OR, 2.01; 95% CI, 1.40–2.90) had higher vaccination initiation than those diagnosed &lt; 9 years.</p> Conclusions <p>HPV vaccination was low among survivors. We found differences in vaccination by age, sex, education, insurance coverage, and age at cancer diagnosis.</p> Implications for cancer survivors <p>These findings provide evidence to guide the development of strategies for improving HPV vaccination and reducing the risk of HPV-related cancers among survivors.</p>